New study links pancreatic cancer to
2 types of bacteria found in gum disease
Published June 07, 2016
Gum
disease may cause more than just bad breath, according to a new study presented
at the 2016 American Association for Cancer Research meeting, which points to a
connection between periodontal disease as a potential early marker for
pancreatic cancer. This could pave the way for early detection of pancreatic
cancer – one of the most deadly forms of the disease –because of the advanced
stage at which it is often diagnosed.
It
is estimated that in 2016, 53,070 new cases of pancreatic cancer will be
diagnosed with only 7.7 percent of victims surviving 5 years.
Researchers
from New York University (NYU) Langone Medical Center with a grant from the
National Cancer Institute, found people with two types of periodontal
disease-causing oral bacteria have a higher prevalence of pancreatic cancer
than those who did not have the gum disease.
The
two types of periodontal disease bacteria the research team found werePorphyromonas
gingivalis and Aggregatibacter actinomycetemcomitans.
Saliva samples came from 361 individuals who developed pancreatic cancer and
samples from 371 matched healthy individuals in large-scale, long-term
prospective cohort studies. The DNA extracted from the saliva was sequenced,
and variances in age, race, sex, smoking status, alcohol use, body mass index
and diabetes were controlled.
Participants
with Porphyromonas gingivalis in the microbiome of their oral
cavity had a 59 percent greater risk of pancreatic cancer than participants who
did not have it. The association of participants with Aggregatibacter
actinomycetemcomitans was not as statistically significant even though
they had at least a 50 percent increased relative risk of developing pancreatic
cancer.
These
findings support the current study’s hypothesis and previous research showing
that people who have developed pancreatic cancer tended to have poor oral
health. The researchers reasoned that periodontitis, which is inflammation of
the tissue around the teeth often causing shrinkage of the gums and loosening
of the teeth, is due to oral bacteria dysbiosis. Dysbiosis is a term for an
unhealthy change in the normal bacterial ecology of a part of the body, such as
the mouth.
Many previous studies have shown a strong relationship
between associated periodontal disease with pancreatic cancer..
Findings from a 2013 European prospective cohort study showed having high levels of P gingivalis antibodies in blood caused a 2-fold increase of developing pancreatic cancer. Another 2007 prospective cohort study looked at over 50,000 male health professionals with a history of periodontitis and found a 64 percent increased risk of pancreatic cancer. Both of these previous studies however, were unable to determine which came first, poor oral health or pancreatic cancer.
Findings from a 2013 European prospective cohort study showed having high levels of P gingivalis antibodies in blood caused a 2-fold increase of developing pancreatic cancer. Another 2007 prospective cohort study looked at over 50,000 male health professionals with a history of periodontitis and found a 64 percent increased risk of pancreatic cancer. Both of these previous studies however, were unable to determine which came first, poor oral health or pancreatic cancer.
This
new study from NYU is the first study to determine that periodontal dysbiosis
does in fact precede the development of pancreatic cancer and does not develop
after the diagnosis. This was determined by looking at the oral samples of
saliva collected prior to the onset of pancreatic cancer confirming the
positive association with P gingivalis.
Researchers
pointed out that this finding does not confirm that the two periodontal
disease-causing bacteria cause pancreatic cancer. Rather, they most likely
correlate it with systemic inflammation occurring within the body, known to be
a precursor for developing cancer. Having periodontal disease-causing bacteria
in the mouth may increase the likelihood of inflammation.
Symptoms of pancreatic cancer
The pancreas is located deep within the abdomen sandwiched between the stomach and the spine, with a small portion of it nestled in the curve of the upper portion of the small intestine. It functions as a glandular organ having an essential role in converting the food we eat into fuel for the body’s cells. It has an exocrine function of secreting digestive enzymes into the small intestine helping with digestion, and an endocrine function of releasing the hormone insulin into the bloodstream, a critical controller of blood sugar levels.
The pancreas is located deep within the abdomen sandwiched between the stomach and the spine, with a small portion of it nestled in the curve of the upper portion of the small intestine. It functions as a glandular organ having an essential role in converting the food we eat into fuel for the body’s cells. It has an exocrine function of secreting digestive enzymes into the small intestine helping with digestion, and an endocrine function of releasing the hormone insulin into the bloodstream, a critical controller of blood sugar levels.
Tumors
of the pancreas are rarely palpable, which is why most symptoms of pancreatic
cancer do not appear until the tumor has grown large enough to interfere with
the functioning of the pancreas, or has spread to other nearby organs such as
the stomach, liver, or gallbladder. Symptoms of pancreatic cancer may include:
·
Upper abdominal pain spreading to
the back
·
Jaundice or yellowing of the skin
and whites of the eyes
·
Diminished appetite and unexplained
weight loss
·
Fatigue
·
Digestive difficulties
·
Nausea
·
New onset of Type 2 diabetes in
people over 50
Risk
factors which may increase the risk of pancreatic cancer include:
·
Cigarette smoking
·
Age – over 80 percent of pancreatic
cancers develop between the ages of 60 and 80
·
Race – more common in African
Americans
·
Gender – more common in men
·
Religious background – more common
in Ashkenazi Jews
·
Chronic pancreatitis
·
Diabetes
·
Obesity
·
Diet – diets high in meats,
cholesterol, fried foods and nitrosamines
·
Family history
Future
additional studies are planned to determine if periodontal disease is a cause
of pancreatic cancer. Until then, good oral hygiene including regular brushing
and flossing of the teeth and visits to a dentist are recommended. If a person
does have periodontal disease, they should be seen regularly by a periodontist
for regular cleanings and checkups to get the condition under control.
Anyone who has any of the potential symptoms of pancreatic
cancer should make an appointment with their physician for an evaluation and
testing as soon as possible.
Dr. Samadi is a board-certified
urologic oncologist trained in open and traditional and laparoscopic surgery
and is an expert in robotic prostate surgery. He is chairman of urology, chief
of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North
Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News
Channel's Medical A-Team and the chief medical correspondent for am970 in New
York City. Learn more atroboticoncology.com. Visit Dr. Samadi's blog at SamadiMD.com. Follow Dr. Samadi on Twitter and Facebook.
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